missing 5th matatarsal

by Jaime
(Bartow, FL)

My daughter was born with a missing 5th matatarsal in her right foot. Now that she is walking and getting older, I have noticed that her leg is bowed in a little bit, she does not really favor that foot any. But I was wondering if there was anything that I could have done so that it begins to grow normally, and that we will be able to find shoes that will fit her properly. She was born with her 5th toe, but after x-rays were done they had decided to just tie the toe off and let it fall off itself. there was no bone for the toe to attatch too. She is missing the entire bone from her ankle to her toe. That being the case, her foot is more narrow then the other, and sometimes she will complain that her hip hurts, I was wondering if there might be any connection between the two.

ANSWER

Hi Jaime,

This is an interesting case as I am not sure that I have ever come across a situation where a fifth metatarsal bone is missing only on one foot.The problem here as your daughter ages, is going to be the ability of the left foot to "function" as close to normal as possible.In a normal gait, after the heel hits the ground the foot comes down and body weight is picked up on the outside of the foot (the fifth metatarsal) where it is then passed on to the ball of the foot and the last part is "toe-off" where the foot propels the body to the next step.The obvious issue here is that your daughter

will not be able to adequately support her weight in what is known as midstance since the fifth metatarsal is missing.Over the years I have seen patients who are missing bones on the outside of their foot either from accidents or surgery and they are able to ambulate.I would actually have to see your daughter walk to give definitive treatment options but on the surface it seems to me she will require at the very least a custom orthotic which is a device that is placed in her shoe in an effort to better balance the foot. Off the top of my head, I am thinking of an orthotic that is built up on the lateral side to make up for the lack of a fifth metatarsal bone. This would stabilize her foot somewhat during midstance and in theory would allow her to get through her gait cycle.You do not mention your daughter's actual age but I take it she is anywhere from 2-5 years old. I would recommend you take her to a foot specialist who can access her gait in regards to her foot and the bowing of her leg.One of the ways that people compensate for bowing of the tibia is to pronate which means they actually put less pressure on the outside of their foot.I think the doctor that you see will have to take the bowing into account when devising an orthotic. This is not a cut and dry situation and make take a little experimentation on the part of you and the doctor to find an orthotic that is helpful to your daughter. Good luck.

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Ontario, Canada
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Fla.
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New York
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Scotland
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J. Simmons

(location unknown)
Dear Dr. Mitnick,
The orthotics arrived four days ago and I slipped them into my shoes immediately. I was skeptical as to the usefulness of the item, they really didn't look very exotic. I have to say though, after using them for just four days, I have experienced grand relief from my foot pain. Even the very first day, I was able to do a lot of work while on my feet with at least a 75% reduction of pain. It has only gotten better every day, and I go nowhere without my shoes with the orthotics.
I had been experiencing extreme heel and sole pain for about six months and had to take extended breaks off my feet many times a day as well as regular doses of Ibuprofen. Since getting the orthotics, my life has returned to normal and I feel good again.
Just wanted to say thanks for the recommendation for a very effective item, I had no idea what a change this item could affect.

Yours truly,

J.C. Forbes

Tennessee
Thanks for the Response, you hit it on the head.

Steve

Redondo Beach, CA
Thank you for your time and expertise in answering my question…..

LH

(location unknown)
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Last June I started having pain and swelling at …….

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(location unknown)
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Madison, Alabama
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Carol

Denison, TX
Dr. Marc,
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Thanks Very Much,

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West lafayette, IN
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Texas
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Tampa, Florida 33624

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UK

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Regards,

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Edmonton,Canada

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South Africa

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Mansfield Ctr, CT

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Placentia, California

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Unknown

Unknown location

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Unknown location

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Pacific Grove, CA

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Alameda, California

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Anonymous

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Catherine

New Zealand

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Thank again!
What a great web site!

Sincerely

Josette

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Arizona
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Thanks, Kathy

Florida
1st of all THANKS A LOT for your great site......

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Poland
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M P

South Carolina
Hello!
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unknown location

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Arlington, VA

Thank you so very much, that would be much appreciated. I love those insoles, by the way. (referring to Superstep orthotics)

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San Clemente, CA

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location unknown

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location unknown

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Bre

location unknown

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anonymous

Dr. Mitnick,
Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

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Poland

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Seattle, WA

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location unknown

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New Jersey

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Excellent information and help to improve One's life.

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Evansville, IA

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San Diego, CA

Dr. Mitnick,
Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better.
So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

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Albany, NY

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Jill S.

location unknown

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Whichita, KS

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mark

Boston, MA

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Colorado

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location unknown
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Canada
I just wanted to say that I am very greatful for
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Wisconsin
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North Carolina
Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida
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Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

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New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

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Lenoir, NC

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Bellevue, WA

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